运动疗法对高血压病患者2年随访观察影响

目的探讨运动疗法在高血压病康复治疗中的作用。方法将136例患者,随机分成:研究组(70例),对照组(66例),进行临床对照分析。两组均接受药物治疗,研究组同时加入运动疗法。运动前及运动后2个月、4个月、6个月分别观察患者的血压、用药情况、随访两年内并发症。结果研究组于运动后平均收缩压与舒张压均有明显下降,与对照组相比差异有显著性意义(P<0.05);停药率与减量服药率明显优于对照组(P<0.01);并发症发生率明显低于对照组(P<0.01)。结论运动疗法加药物疗法较单纯药物疗法在减低血压、改善症状、减少用药、降低并发症等方面均有明显效果。     

全髋置换术后的康复训练计划疗效初探

目的：探讨人工全髋置换术后系统康复训练计划的重要性,并验证其疗效。方法：选择1995年5月－1997年9月股骨颈骨折于我院行人工全髋置换术的患者40 例,随机分两组,进行术后1 月、3 月同期疗效评定。结果：训练组肌力、功能得分明显优于对照组,统计学有显著性差异（P＜0．05）。结论：系统康复训练可提高手术效果,恢复关节功能,同时证明关节置换术后早期系统康复训练是必要的。     

过度训练对大鼠肝脏功能的影响

目的研究过度训练对机体肝细胞功能的影响.方法通过对大鼠进行为期8周的力竭性游泳训练建立大鼠过度训练模型,并测定血清谷丙转氨酶、谷草转氨酶等酶的活性以及三羟胆汁酸(TBA)含量.结果(1)过度训练组血清组谷丙转氨酶和谷草转氨酶的活性均显著高于对照组和1h训练组,谷草转氨酶活性显著高于对照组;(2)过度训练组血清三羟胆汁酸含量显著高于对照组和1h训练组.结论血清酶活性在一定程度上可反映肝细胞的损伤,动态观察静息时血清三羟胆汁酸的含量可特异地反映肝细胞的功能状态.     

腰椎管狭窄症的保守治疗分析

目的 观察鲑鱼降钙素配合物理治疗因腰椎间盘突出所致的腰椎管狭窄症的疗效。方法 将80例因腰椎间盘突出所致腰椎管狭窄症患者随机分成两组，对照组给予常规物理治疗，观察组在此基础上给予鲑鱼降钙素注射治疗。应用目测类比评分法（VAS）、腰部关节活动度、功能独立性评定（FIM）和无痛行走距离、下肢反射情况等进行疗效分析。结果 观察组的VAS评分、腰部关节活动度及无痛行走距离改善情况优于对照组（P〈0．05），但反射的改善和FIM评分两组结果差异无统计学意义（P〉0．05）。结论 鲑鱼降钙素具有能迅速减轻腰椎间盘突出所致腰椎管狭窄症状的作用，尤其是减轻疼痛的作用明显，作为保守治疗方案的选择还有待进一步的研究。     

The effect of mindfulness training prior to total joint arthroplasty on post-operative pain and physical function: A randomised controlled trial

ObjectiveTo evaluate the efficacy of Mindfulness-Based Stress Reduction (MBSR) in improving pain and physical function following total joint arthroplasty (TJA).DesignTwo-group, parallel-group, randomised controlled trial, conducted between September 2012 and May 2017.SettingSingle centre study conducted at a University-affiliated, tertiary hospital.InterventionPeople with arthritis scheduled for TJA, with a well-being score <40 (Short Form-12 Survey) were randomly allocated to a pre-surgery eight-week MBSR program or treatment as usual (TAU).Outcome MeasuresSelf-reported joint pain and function at 12 months post-surgery, assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Secondary outcomes were knee stiffness and global improvement (WOMAC); physical and psychological well-being (Veterans RAND 12-item Health Survey); self-efficacy (Arthritis Self-Efficacy Scale); and mindfulness (5-Factor Mindfulness Questionnaire).Results127 participants were randomised; 65 to MBSR and 62 to TAU, of which 45 participants allocated to the intervention and 56 participants allocated to usual care proceeded to surgery and 100 (99%) completed primary outcome measures. Greater improvements in knee pain (mean difference, -10.3 points, 95% CI -19.0 to -1.6; P = 0.021) and function (mean difference, -10.2 points, 95% CI -19.2 to -1.3; P = 0.025) at 12 months post-surgery were observed in the MBSR group compared to the TAU group. A between group difference in global scores (-9.5 points, 95% CI -17.9 to -1.1; P = 0.027) was also observed. No other differences in secondary outcomes were observed.ConclusionMBSR improves post-surgery pain and function in people with psychological distress undergoing TJA. Further research is required to examine potential barriers to broader implementation and uptake.     

普拉提训练课程对大学女生身体素质提升的效果

目的研究普拉提核心力量训练对大学女生形态、心肺功能、平衡能力及灵活性指标的影响。方法40个大学女生按实验目的分为常规体育课程组(CK组)及普拉提训练课程组(PM组),PM组训练强度为每周2次时间为60~80 min的普拉提训练,训练持续16 w,训练前后测定形态、心肺功能、平衡能力及灵活性指标。结果协方差分析结果表明,普拉提训练课程能够显著影响大学女生心肺功能、灵活性及身体平衡能力。通过前后测试指标比较分析,PM组前测和后测数据有显著差异,其中大学女生体重显著下降1.09%(t=2.709;P=0.014),大腿围显著下降0.34%(t=2.554,P=0.019),腰围显著下降0.99%(t=4.223,P=0.000)、腰部皮褶厚度显著下降4.25%(t=4.908,P=0.000)、腹部皮褶显著下降1.54%(t=5.329,P=0.000)。PM组心肺功能呈现显著提升,其中肺活量显著增加27.05%(t=-26.544,P=0.000),最大吸氧量显著增加4.89%(t=-10.141,P=0.000),每搏输出量显著增加4.23%(t=-15.143,P=0.000),心率显著下降3.06%(t=4.886,P=0.000);PM组的柔韧性指标也呈现显著变化,坐位体前屈显著上升47.04%(t=-30.368,P=0.000),仰卧起坐次数显著增加45.70%(t=-17.512,P=0.000),Romberg显著提升达91.41%(t=-11.451,P=0.000),功能性伸展显著提升6.55%(t=-6.128,P=0.000)。结论普拉提运动能有效提升大学女生心肺功能、平衡能力及机体灵活性。     

The effect of psychomotor physical therapy on subjective health complaints and psychological symptoms

Background and Purpose. The objective of this study was to examine the effect of Norwegian psychomotor physical therapy on subjective health complaints and psychological symptoms. Method. A non‐randomized waiting list controlled design was used. Physiotherapists in Norway recruited patients for a treatment group (n = 40) and waiting list control group (n = 22). Patients on the waiting list could only be included for 6 months, as they then started treatment. Symptoms registration was obtained from both groups at baseline and 6 months, and only for the treatment group also at 12 months. The following self‐report forms were used; Subjective Health Complaints Inventory (SCH); Beck Depression Inventory‐II (BDI‐II); Spielberger State‐Trait Anxiety Inventory‐Trait (STAI‐T); Bergen Insomnia Scale (BIS); Fatigue Questionnaire (FQ); Quality of Life Inventory (QOLI); The Client Satisfaction Questionnaire (CSQ). Results. The patients had had widespread and clinically significant health problems for an average of 9 years upon entrance to the study. After 6 months in psychomotor physical therapy, all the measured symptoms in the treatment group were significantly reduced, but only quality of life was significantly reduced when compared to the waiting list control group. After 12 months in therapy, the patients in the treatment group had continued to improve on all measured variables. The symptoms of anxiety and depression, as well as quality of life, were improved from clinical to non‐clinical level. Conclusions. Norwegian psychomotor physical therapy seems to have potential for reducing symptoms of subjective health complaints, depression, anxiety, insomnia, fatigue and improving quality of life, although the process takes time. Further research is needed to gain more rigorous data, and randomized controlled studies are highly welcomed. Copyright © 2010 John Wiley & Sons, Ltd.     

镜像疗法结合运动想象训练对脑卒中后偏瘫患者上肢功能和日常生活活动能力的影响

目的 观察镜像疗法结合运动想象训练对脑卒中后偏瘫患者上肢运动功能和日常生活活动(ADL)能力的影响.方法 将脑卒中后偏瘫患者44例按随机数字表法分为治疗组和对照组,每组患者22例,所有患者均接受常规的康复训练.治疗组增加镜像疗法和运动想象相结合的作业治疗,对照组则增加常规作业训练.2组患者均于治疗前和治疗6周后(治疗后)采用Brunnstrom分期、偏瘫上肢功能测试(香港版)(FTHUE-HK)和Barthel指数(BI)评分分别评价其上肢和手的运动功能以及ADL能力.结果 治疗后,治疗组患者的Brunnstrom分期、FTHUE-HK评分和BI评分分别为(4.55±0.86)级、(5.73±1.03)级和(73.50±10.89)分,对照组则分别为(3.90±1.02)级、(4.55±1.34)级和(67.05±12.03)分,2组各项指标与组内治疗前比较,差异均有统计学意义(P＜0.05),且治疗组各项指标显著优于对照组(P＜0.05).结论 镜像治疗结合运动想象训练可有效地改善脑卒中偏瘫患者的上肢功能和ADL能力.     

The effect of physical therapy on balance of patients with Parkinson's disease

Physical therapy can improve performance of balance tests in patients with Parkinson's disease. Parkinson's disease is a chronic progressive neurological disturbance with significant effect on movements, cognitive functions, autonomous systems and psychosocial activities. The effects of physical therapy are rarely reported and not sufficiently studied. This prospective study comprised 40 persons with stage III Parkinson's disease, according to aged over 50 years and 20 healthy controls of the same age. Patients were medically stable and had no other neurological deficits, postural hypotensia, visual disturbances or musculo-skeletal deficits. Balance tests before and after physical therapy were analysed according to. Balance tests in patients with Parkinson's disease resulted in significant differences of values for tandem stance, one leg stance, step test and external perturbation when compared to the controls, and between groups with and without falling tendency. Tandem stance, one leg stance, step test and external perturbation can be used for differentiation between groups with and without a tendency to fall. Physical therapy resulted in significant improvement of these tests in both the groups analysed. Systematic application of physical therapy, as part of team treatment, improves the balance of patients with Parkinson's disease.     

Combined effects of repeated sauna therapy and exercise training on cardiac function and physical activity in patients with chronic heart failure

Purpose: We investigated the combined effects of repeated sauna therapy and exercise training on subjective symptoms, cardiac function, daily activities and ambulation capacity in patients with chronic heart failure. Methods: Fifty four patients including 26 patients with repeated sauna therapy and exercise training (combined therapy group) and 28 patients with repeated sauna therapy (monotherapy group) participated in the study. Repeated sauna therapy and exercise training were performed once a day, 5 days a week. Clinical symptoms, brain natriuretic peptide concentration, cardiac functions evaluated by echocardiography, cardiac size on chest radiography, Barthel Index (BI) and ambulation capacity were examined and compared between the time of hospital admission and the time of discharge. Results: Both the groups showed significantly improved New York Heart Association functional class, cardiothoracic ratio, brain natriuretic peptide concentration, left ventricular ejection fraction, BI score and ambulation capacity grade. The changes of New York Heart Association functional class, BI score and ambulation capacity in the combined therapy group were a higher level of statistical significance than those in monotherapy group. Notably, significant between group difference was observed in the changes of BI score. Conclusions: The addition of exercise training programs to repeated sauna therapy may be efficient and effective for improvement of cardiac function and daily activities for patients with chronic heart failure.

• Implications of Rehabilitation

• Repeated sauna therapy is an effective means of improving cardiac, vascular function and mental health in CHF patients.

• Exercise training is an effective means of improving exercise capacity, thus improving ADL.

• Combination of repeated sauna therapy and exercise training may be recommended as a comprehensive treatment to improve cardiac function, ambulation capacity, and ADL in CHF patients.

     

The effect of combined therapy (spa and physical therapy) on pain in various chronic diseases

OBJECTIVE: Spa therapy is commonly used in the treatment of daily chronic diseases practice, but its benefits are still the subjects of discussion. This study investigates possible effects of a combined spa and physical therapy program on pain and hemodynamic responses in various chronic diseases. METHODS: The pain intensity and hemodynamic responses of 472 patients involved in a spa and physical therapy program were studied retrospectively. Assessment criteria were pain [Visual Analog Scale (VAS)] and hemodynamic responses (heart rate, blood pressure, respiratory rate). Assessments took place before, immediately after treatment, and after completion of the spa program (before discharge). RESULTS: The patients with ankle arthrosis, fibromyalgia and cervical disc herniation reported the highest VAS score before treatment program (P < 0.05). After the therapy program, VAS scores were seen to decrease compared to before treatment (P < 0.05). The patients with osteoarthritis of the hip (1.3+/-1.2) and soft tissue rheumatism (1.3+/-1.2) had the lowest VAS score before discharge compared to patients with other pathologies (P < 0.05). No statistically significant differences were detected between both sexes in terms of pain improvement (P > 0.05). On discharge, all hemodynamic responses decreased significantly compared to before and immediately after initiation of the therapy program (P < 0.01). CONCLUSION: To decrease pain and high blood pressure without hemodynamic risk, a combined of spa and physical therapy program may help to decrease pain and improve hemodynamic response in patients with irreversible pathologies.     

运动训练对慢性心力衰竭患者胰岛素抵抗的影响

目的观察慢性心力衰竭（CHF）患者胰岛素抵抗（IR）状态及运动训练对IR的影响。方法将120例心功能Ⅱ～Ⅲ级的CHF患者（观察组）随机分为训练组（n=65）和常规治疗组（n=55），2组患者均接受常规的抗心衰药物治疗，训练组还接受每天2次6min步行运动训练，连续20周。比较2组患者治疗前、后胰岛素抵抗指数（HOMA-IR）、胰岛素敏感指数（ISI）、左室射血分数（LVEF）、左室短轴缩短率（LVFS）、6min步行距离、心率（HR）及平均血压（MBP），并将观察组治疗前的HOMA-IR、ISI与对照组（n=32）比较。结果与对照组相比，观察组ISI降低，HOMA-IR增加（P〈0．01）。治疗后，观察组LVEF值、LVFS、6min步行距离及ISI升高，而HR、MBP及HOMA-IR降低。相对于常规治疗组，训练组治疗后LVEF、LVFS、6min步行距离、ISI增高和HOMA-IR、HR、MBP降低的程度更明显（P〈0．05）。结论CHF患者存在IR，运动训练在改善其心功能及运动功能的同时，也能改善其IR。     

认知功能训练对脑损伤后记忆障碍的影响

目的探讨认知功能训练对脑损伤后记忆障碍的影响及临床意义。方法将82例脑损伤患者设为研究组,79例同期来本院体检的健康人设为对照组,研究组在常规治疗护理的基础上给予5周的认知功能训练,在训练前,训练后分别进行韦氏记忆量表(WMS)测评。结果脑损伤后训练前,患者的长时记忆、短时记忆、瞬时记忆的各项分测验评分,以及记忆智商均明显低于对照组(P<0.05)。5周训练后WMS测评中,除回忆与训练前无显著差别外,其他各项分测验值以及记忆智商均明显优于训练前(P<0.05)。结论脑损伤后患者的记忆功能明显受到损害,早期认知功能训练可改善记忆障碍。     

应用平衡功能检测训练系统改善脑卒中患者平衡功能的疗效观察

目的 观察应用PH—A型平衡功能检测训练系统对脑卒中偏瘫患者进行平衡功能训练的疗效。方法 将108例脑卒中偏瘫患者分为治疗组（68例）和对照组（40例）。对照组给予常规药物治疗和物理因子治疗，治疗组在常规治疗的基础上同时应用PH—A型平衡功能检测训练系统对患者进行平衡功能训练，2组患者在治疗前、后分别应用该系统检测和Berg平衡功能评定表（BBS）进行评定。平衡检测分别在坐位、双足站立位（睁眼和闭眼状态下）进行，取摆幅指数、重心分布区域、摆动的轨迹长、外周面积4个指标进行分析。结果 2组患者治疗后BBS评定和平衡检测均有明显改善，其中治疗组的坐位分布区域好转，但无统计学意义（P〉0．05），BBS评定和平衡检测站立位各指标均有显著好转（P〈0．001）；治疗后2组比较差异有统计学意义（P（0、05～P〈0、01），治疗组临床疗效明显优于对照组。结论 运用PH—A型平衡功能检测训练系统对偏瘫患者进行平衡功能训练，可以显著提高患者的站立平衡功能。     

自我管理训练对癫痫患者心理及社会功能的影响

目的探讨自我管理训练对癫痫患者心理及社会功能的影响。方法将112例癫痫患者随机分为实验组和对照组，对照组实施常规健康教育，实验组进行自我管理训练，内容包括建立健康档案、与患者建立良好的护患关系、制定自我管理教育处方等。两组患者出院1年后采用症状自评量表、社会功能缺陷筛选量表进行效果评价。结果训练后实验组患者症状自评量表和社会功能缺陷筛选量表评分低于对照组（P〈0．01）。结论自我管理训练可改善癫痫患者的心理障碍，对其社会功能恢复具有积极的促进作用。     

镜像疗法联合头穴透刺应用于脑卒中后患者下肢功能康复训练的疗效观察

目的:探讨镜像疗法联合头穴透刺对脑卒中后患者下肢功能恢复的临床疗效。方法:收集2016年3月—2017年7月在浙江省人民医院康复医学科住院的符合纳入标准的卒中患者120例,随机分为头穴透刺组(40例):常规治疗+头穴透刺;镜像疗法组(40例):常规治疗+镜像疗法;联合疗法组(40例):常规治疗+镜像疗法+头穴透刺。并分别于治疗前,治疗8周后,对患者进行踝背伸角度测量、下肢Fugl-Meyer、Berg平衡量表、Barthel指数、步态评估量表评定,比较三组对患者踝背伸、下肢运动功能及步态的改善。结果:①组内比较:治疗后三组的各项评分均较治疗前有显著提高(P0.01)。②组间比较:治疗前,三组的各项评分比较均无显著性差异(P0.05);治疗后,镜像疗法组的各项评分均显著优于头穴透刺组(P0.05),联合疗法组的各项评分均显著高于头穴透刺组(P0.01)与镜像疗法组(P0.01)。结论:头穴透刺与镜像疗法均可显著改善卒中患者的下肢功能,镜像疗法联合头穴透刺对改善卒中患者的下肢功能更为显著。     

联合训练器训练配合矿泉浴对飞行员身体耐力的影响

本文观察４０例歼击机飞行员采用联合训练器训练配合矿泉浴，对＋Ｇ值耐力、左心功能（ＬＨＦ）和脑电阻图（ＲＥＧ）的影响，并与常规体育训练配合矿泉浴（对照组Ⅰ）和单纯常规体育训练（对照组Ⅱ）进行了对比研究。结果表明：观察组训练前后三项指标自身对比与对照组对比变化显著（Ｐ＜０、０１），对照组Ⅰ较对照组Ⅱ变化明显。表明联合训练器训练配合矿泉浴是矫治飞行员加速度耐力不良的有效方法；兴城矿泉浴对增强飞行人员身体素质有良好作用。关键词